Insurance and Billing Specialist

RightSite Health; United States; On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Competitive base salary

Healthcare coverage including medical, dental, vision

Opportunity for professional growth

Job summary

A healthcare organization is seeking an Insurance and Billing Specialist responsible for managing the billing cycle, from insurance verification to claim submission. The ideal candidate will possess strong knowledge of medical billing practices, attention to detail, and problem-solving skills. Responsibilities include verifying insurance coverage, submitting claims, and auditing financial records. This position offers a competitive salary and the chance to impact community health while working in a mission-driven environment.

Qualifications

• 2 years of experience in medical billing and insurance verification.
• Strong knowledge of CPT and ICD-10 coding.
• Familiarity with HIPAA regulations and privacy standards.

Responsibilities

• Verify insurance coverage and load insurance information.
• Submit claims to billing partner.
• Conduct claim audits and reconciliations.
• Perform front-end edits on patient demographics and ensure data accuracy
• Conduct claim audits and reconciliations for accuracy
• Research uninsured/unknown insurance cases for potential coverage
• Assist in billing automation implementation and testing
• Audit billing automations for accuracy and efficiency
• Liaise with Operations to identify data collection improvements
• Serve as SME for Navigators on insurance-related questions

Skills

Medical billing practices

Attention to detail

Problem solving

Communication skills

Technical proficiency

Education

Bachelor's degree in healthcare administration or related field

Tools

Medical billing software

Excel

Job description

Who We Are

We are changing how EMS navigates care! RightSite partners with EMS on-site to connect non-emergent patients with a Telehealth ER Doctor and navigate them to the right site of care. Patients instantly access an ER Telehealth Doctor and a Patient Navigator who provide a trusted, genuine human connection in a time of need. EMS becomes more available for critical emergencies while we deliver higher quality care at a lower cost and better experience for everyone.

Who You Are

The Insurance and Billing Specialist will be responsible for managing all aspects of the billing cycle, from insurance verification to claim submission and reconciliation. This dynamic role requires a strong understanding of medical billing practices, attention to detail, and the ability to work independently as well as collaboratively with other departments. As a crucial member of our team, you will leverage your expertise to optimize revenue cycles, ensure compliance with industry regulations, and contribute to the financial health of our organization. Your skills in navigating complex insurance systems and resolving billing discrepancies will be instrumental in maintaining smooth operations and enhancing patient satisfaction.

If you would like the opportunity to make a tangible impact on community health while working for a dynamic, mission‑driven organization, we would love to hear from you!

A DAY IN THE LIFE

• Verify insurance coverage and ensure accurate loading of insurance information for billing purposes
• Submit claims to our billing partner
• Create invoices for case rates and other billing scenarios as needed
• Perform front‑end edits on patient demographics, correcting information such as date of birth, addresses, and member IDs
• Conduct claim audits and reconciliations to ensure all services are accounted for and billed correctly
• Research uninsured and unknown insurance cases to identify potential coverage
• Assist in the implementation and testing of billing automation processes
• Perform ongoing audits of billing automations to ensure accuracy and efficiency
• Serve as a liaison with Operations, identifying opportunities for improvement in front‑end data collection
• Serve as a SME (Subject Matter Expert) for Navigators on insurance‑related questions

Requirements

• Bachelor's degree in healthcare administration, business, or related field or equivalent experience
• Minimum 2 years of experience in medical billing and insurance verification
• Proficiency in medical billing software
• Strong knowledge of CPT and ICD‑10 coding
• Familiarity with HIPAA regulations and privacy standards

COMPETENCIES

Medical Billing Expertise

Comprehensive knowledge of medical billing practices, insurance claim processes, and healthcare reimbursement systems. This includes understanding various coding systems, payer requirements, and regulatory compliance.

Attention to Detail

Meticulous focus on accuracy when handling patient information, insurance data, and financial records. This skill is crucial for minimizing errors in claim submissions and ensuring proper revenue capture.

Problem Solving Skills

Ability to analyze complex billing issues, identify discrepancies, and develop effective solutions. This competency is essential for resolving claim rejections, auditing billing processes, and optimizing revenue cycles.

Communication

Proficiency in clearly conveying to health plans billing irregularities and working with them to resolve issues.

Technical Proficiency

Strong aptitude for using billing software, Excel and data analysis tools. This competency is vital for managing automated billing processes, conducting audits, and improving operational efficiency.

Benefits

• The opportunity to be a part of a dynamic, mission‑driven organization
• Competitive base salary
• Market‑competitive healthcare coverage, including medical, dental, vision, life, and disability
• The opportunity to work alongside talented and professional colleagues with the ability to grow

OUR GUIDING VALUES

Teamwork

We have the courage to ask for help and fearlessly share information with team members. We are driven to help each other and share in the wins and losses.

Integrity

We are respectful, genuine, and openly hear and speak the truth. We are confident in our own abilities, but we think of others first.

Customer Focus

We deliver value and treat our customers with the same care, compassion, and empathy we would expect ourselves. We are committed to improving the lives of our customers, their customers, and each other.

Tenacity

We recognize ambiguity and discomfort are part of success, and approach change with positivity. We accept adversity, overcome obstacles, and never give up.

Ownership

We take personal accountability for our actions and results and focus on solving the problem instead of assigning blame. We are free to place bets and embrace failure for its feedback and experiences.

Critical Thinking

We start with why, listen carefully and investigate thoroughly before drawing conclusions. We think slow, not fast, in search of elegant and simple solutions.